Is Pelvic PT Right For You?
Take this short quiz to determine whether Pelvic PT is a good fit for you!
If you score above a 3/12, then it would be in your best interest to see a Pelvic Floor Specialist!
Made with guidance from The Cozean Pelvic Dysfunction Screening Protocol
Email address *
Type Your Name: *
Your answer
Have you ever been pregnant, are you pregnant, or are you planning to become pregnant? *
1 point
Did you have any tearing during giving birth? *
1 point
Do you ever have pelvic pain (in genitals, perineum, pubic or bladder area, or with urination) that exceeds a '3' on a 1-10 scale? *
1 point
Do you have pain with sex? Or after sex? *
1 point
Do you pee more than 10 times per day? *
1 point
Do you pee more than 2 times at night? *
1 point
Have you experienced any of the following: *
1 point
Required
Have you noticed a separation of your stomach muscles? Or bulging in your stomach? *
1 point
Do you know how to do a proper kegel? *
1 point
Have you ever had any falls onto your tailbone, low back, or buttocks region? Even if it was when you were a child. *
1 point
Do you have an increased sensation of pressure in your pelvic region, or feel as if your insides are falling out of your vagina or rectum? *
1 point
Do you have a history of any of the following orthopedic impairments: *
1 point
Required
A copy of your responses will be emailed to the address you provided.
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